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Drugs Wrongly Prescribed to
Seven Million Elderly - Study
December 11, 2001
CHICAGO (Reuters) - One in five elderly Americans has been inappropriately prescribed drugs such as tranquilizers and antidepressants that can leave them dazed, groggy, or susceptible to falls, a study said on Tuesday.
An estimated 21 percent, or nearly 7 million Americans older than 65, received prescriptions in 1996 for at least one of 33 drugs deemed by a panel of experts to be inappropriate for use by the elderly because of potentially dangerous side effects.
While the improper prescribing of several drugs on the list has declined over the past decade, those in poor health and elderly women are at greater risk of getting the wrong medication, study author Dr. Chunliu Zahn of the Agency for Healthcare Research and Quality in Rockville, Maryland, wrote in this week's issue of the Journal of the American Medical Association.
In an accompanying editorial, Dr. Jerry Avorn of Harvard Medical School wrote: "Elderly patients are falling and sustaining hip fractures because of the overuse and misuse of a wide variety of more modern agents, even those short half-life tranquilizers and hypnotics that would never make it onto any most wanted list of inappropriate drugs."
"Some patients are being labeled with diagnoses of new illnesses, or are simply viewed as 'just getting old' when they manifest adverse effects of anti-psychotic drugs used to excess," Avorn's editorial said.
With a Medicare prescription drug benefit under consideration for the federal health program for the elderly, the risk that drugs will be improperly prescribed may rise, study author Zahn wrote. He urged that measures be taken such as educating physicians and patients about inappropriate drugs.
Avorn suggested that government health authorities needed to do more to monitor the problem.
"With the demographic tidal wave of increased numbers of elderly patients continuing its sweep through the industrialized world, the current view of problematic drug use in elderly patients will have to be broadened beyond an every-few-years snapshot of how many elderly patients were prescribed outmoded drugs identified from a 'gotcha' list that is itself becoming elderly," Avorn wrote.
The study said 11 prescription drugs that should always be avoided by the elderly fell into the categories of barbiturates, chlorpropamide, dicyclomine, hyoscyamine and belladonna preparations.
Eight drugs deemed rarely appropriate for the elderly were in the categories of propoxyphene, diazepam, cyclobenzaprine and cariosoprodol.
Fourteen drugs often misused by the elderly included amitriptyline, dipyridamole, promethazine, hydroxyzine, and diphenhydramine.